Scleroderma is a rare disease caused by the immune system targeting and damaging healthy connective tissue, an important structural component of organs, bones, and skin. This leads to inflammation, causing damage and swelling, and fibrosis (scarring) because of an overproduction of collagen.
COX-2 inhibitors are a type of anti-inflammatory agent that may be prescribed to treat disease symptoms, such as the joint and tendon pain experienced by scleroderma patients.
What are COX-2 inhibitors?
COX-2 inhibitors are a subset of non-steroidal anti-inflammatory drugs (NSAIDs) that act specifically on the enzyme cyclooxygenase-2 (COX-2).
As part of the immune response to infections or injury, COX-2 facilitates the release of prostaglandins (synthesized from a substance called arachidonic acid). Prostaglandins play a key role in triggering inflammation.
Chronic inflammation can be a source of pain and can lead to permanent damage in scleroderma. By blocking the production of prostaglandin, COX-2 inhibitors work to reduce the level of inflammation and complications associated with it. In scleroderma patients, these inhibitors can help to reduce the swelling, stiffness, and pain that inflammation causes in the joints.
Types of COX-2 inhibitor
Another such medication, Vioxx (rofecoxib), was voluntarily recalled in the mid-2000s due to safety concerns and is no longer available by its brand name, although generic versions may be in use. Bextra (valdecoxib), also a COX-2 inhibitor, was voluntarily recalled from the U.S. market in 2005 for safety concerns; it may be available elsewhere.
COX-2 inhibitors may be preferred over common NSAIDs, as they may cause fewer side effects. Traditional NSAIDs, such as ibuprofen, block another enzyme, called COX-1, alongside COX-2. COX-1 plays a role in the stomach, so NSAIDs can cause gastrointestinal side effects such as diarrhea and stomach ache.
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